Viewpoint: Happy 65th birthday NHS and why more general practice spending is needed

Happy 65th birthday NHS - still one of the greatest achievements in history!

Prof Gerada: 'Essential the government responds to our call for more spending in general practice.'
Prof Gerada: 'Essential the government responds to our call for more spending in general practice.'

None of us can predict the future but, whatever it holds, it is important to have a vision. As GPs it is our job to care – and this will not change - but the way we deliver care to our patients is going to change and so are our patients, so it is essential that we are prepared.

When we look forward we need to be pragmatic. We need to anticipate the challenges that lie ahead and formulate a plan that guarantees the future sustainability of general practice - and the NHS - in the best interests of our patients.

The college’s landmark vision for the future of general practice: The 2022 GP does just this. It gives us a series of goals to work towards, and an action plan for how to meet them to ensure the best possible care for our patients whilst maintaining a sustainable, good value NHS.

More necessary to provide whole-person care

Our vision puts patients right at the heart of general practice, looking at ways that we can be better GPs and offer more and different services to our patients - and at the same time ease some of the unworkable pressures that we are currently facing.

The important thing is that our patients trust us and we need to retain their trust as we deal with increasing pressures coupled with depleting resources.

As our population ages and patients are routinely presenting with complex and multiple morbidities, both physical and mental, it is becoming more necessary to provide whole-person care as opposed to just treating individual conditions - and more important to deliver greater continuity of care and integration between primary, secondary and social care.

The 10-minute consultation, for example, is out of date. In the future we need to be able to offer more flexible consultations to meet the needs of individual patients. We need to start working within federations of practices and act as guides for our patients as they navigate an ever more complex health service.

Challenges ahead are daunting

In the future GPs also need to start making more use of IT when caring for our patients. Remote consultations by telephone, over the internet, email, text message and even social media will increase the capacity of GPs to see many more patients, and at more flexible and convenient times.

The future will also see a greater emphasis on self-care and patients referring to e-health information systems.

I know the challenges ahead are daunting, especially when our workloads are ballooning and we are working longer and longer hours, seeing more patients. In our recent RCGP survey, 85% of respondents said that they thought general practice was now 'in crisis' and four out of five GPs said they could no longer guarantee safe patient care.

But I also know that as our patients and the NHS become more complex, they need us more than ever.

This is why it is essential that the government responds to our call for more spending in general practice - and for more GPs. We provide the most cost-effective care in the NHS but it is unsustainable for us to keep making 90% of all patient contacts for only 9% of the NHS budget.

* An edited version of this Viewpoint will appear in the 8 July edition of GP.

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